In the Western world 30% of all deaths is due to ischemic heart disease, i.e. coronary atherosclerosis. In about 70% of these deaths acute ventricular fibrillation causes the circulatory arrest. In about 30% of these deaths electromechanical dissociation, i.e. heart arrest without ventricular fibrillation, is the reason for acute death. Most of these deaths occur outside hospitals. Before effective cardiopulmonary resuscitation can be initiated several minutes without any form of cardiac massage often occur. When the heart does not receive blood and energy, the ionic pumps of the heart muscle cells become more and more inefficient which results in an increase of the intracellular concentration of calcium. When the intracellular concentration of calcium increases, the contractile state of the heart increases. Ultimately, a condition described as “stone heart” or ischemic contraction of the heart occurs. Cooley described in 1972 an ischemic contraction condition of the heart and called it “stone heart”. He described the heart in these cases as small and irreversibly contracted, and it appeared to be literally frozen in systole, as certain protein structures of the heart muscle cells are irreversibly disrupted. If such a condition occurs during cardiopulmonary resuscitation, it is not possible to perform effective external or internal heart massage, because there will be no lumen left in the ventricles and therefore no possibility for the blood to pass through the heart. The clinical result of cardiopulmonary resuscitation as it is practiced today for patients dying outside hospital is very poor, with a mortality of around 97-98%. In most cases, it is not possible to perform effective heart massage 20 minutes after the cardiac arrest, and in some countries there is a recommendation that if you can not bring the heart to work within 20 minutes, you may declare the patient dead and stop all types of cardiopulmonary resuscitation.
When a patient's heart today stops outside a hospital the general population has been trained in doing cardiopulmonary resuscitation. This consists of mouth to mouth blowing in of expiratory air and manual compression of the chest, i.e. 5 compressions of the chest, followed by 1 inblow of expiratory air or 2 inblows and 15 chest compressions. A cardiac output of about 10-15% of the normal output in rest may be obtained by manual external chest compression, and this low output is not enough to give the heart enough blood to survive more than for a few minutes. If especially well trained personnel arrive to the accident place, defibrillation of the heart is tried if ventricular fibrillation is diagnosed, and the patient is intubated and ventilated with 100% oxygen. It is also very difficult to transport a patient having circulatory arrest into hospital because it is not possible to perform effective external chest compression during transportation in the ambulance. For that reason most of these patients are declared dead if they not can be saved on the accident place. Thus, there is a great world-wide need to develop methods and means for treatment of such patients also under transport until access to adequate artificial circulation means at hospitals or other medical centres.